Why can’t we make a baby? #NIAW

Why?  Why me?  Why can’t I make a baby like all my other friends and family? I have so many questions about why after almost 2.5 years of trying to conceive and failing miserably, month after month.  What have I done to cause this?  Why won’t my body just get pregnant? What am I doing wrong?

It’s human nature to want to know why things happen.  But these are the type of questions that run through my head round and round, continuously ever since we decided to grow our family.  I have yet to answer any of these questions.  It is exhausting.

Chris and I are 1 in 8 couples of child bearing age in the US that struggle with the disease that is infertility.  We tried the good old fashioned way – sex – for 11 months before we went to seek specialist help from a reproductive endocrinologist doctor after we discovered that Chris’s testosterone levels were “below normal”.  It turned out for us that testosterone levels do not actually matter that much when it comes to fertility.  Chris actually had super sperm, and lots of them!  But it did lead us to start the typical tests for diagnosing infertility.

We thanked our lucky stars that all our test results came back normal – there was nothing seriously wrong with either of us.  In fact, we passed all our tests with flying colours, we were top of the class!  But this put us into the category that 20% of infertile couples are diagnosed with – unexplained infertility.  This meant that the doctors could not tell us why we hadn’t been successful so far in trying to conceive the way they teach you at school.  We were about to embark on a journey that was going to take us beyond what they taught us at school – we were going to try to get pregnant with medical assistance.  We were heading into the world of the unknown.  We knew little to nothing about infertility.

At first it was difficult to explain to our friends and family why we were seeking treatment, because there was nothing ‘technically’ wrong with us.  The infertility was inexplicable!  It was embarrassing, it was awkward to explain.  So this is why I started this blog, to help us get over this difficulty in explaining what we were doing and why, as well as helping to explain our feelings about our disease in general.

Unexplained infertility in someways has been a good thing – there is always hope that this treatment will work.  But ultimately it is difficult to accept that there is just no known reason that this isn’t working for us.  In some cases, going through medically assisted treatment for infertility can reveal the explanation of a couple’s infertility.  But in our case, after 3 IUIs (Artificial Insemination) and 3 cycles of IVF (In-Vitro Fertilisation), 1 suspected ectopic pregnancy,  and over $90k of medical bills we are none the wiser as to why we do not have a baby in our arms yet.

Conception is a wondrous act of nature, but it is also an incredibly complex process  – there have to be many stars in line for a healthy baby to be born.  For something that is the very basis of our human race’s existence, we still know very little about the disease that prevents us from growing our families.  It’s incredible, right?

I am currently in the dreaded two week wait of our third (and final) IVF cycle.  If this cycle fails, apart from being devastated, I do not know how we will ever be able to move forward without knowing why this has happened, why medical treatment didn’t work for us.  Our infertility will never leave us.

For National Infertility Awareness Week (NIAW), the national non-profit infertility organisation Resolve is promoting this year’s theme #StartAsking.  The theme is about promoting the questions that we want to be answered, whether this is asking for our Employers to provide insurance coverage, asking for legislation that supports family building options or asking our friends and family to support us.  For me, the one question I have and want to raise more awareness about is to:

 #StartAsking for more targeted research on unexplained infertility.

Perhaps if we can understand more about how or why some couples are infertile, then better focused medical interventions can be developed to defeat infertility.

I want answers!!!! But we won’t ever get answers if we don’t talk about infertility and unexplained infertility.  It shouldn’t be a secret.  We can do this by speaking openly about infertility, by getting organisations like Resolve to help raise our community’s voice and build awareness.

If you would like to know more about infertility, please visit Resolve.org.

If you would like to help, you can contribute by fundraising or donating for Resolve.  Or just comment below with your questions and thoughts to join in the discussion!

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Mega Communication FAIL

I am upset at myself….Chris told me it doesn’t matter, but I can’t help but feel like an idiot about it.

2 months ago I went to my normal physician and had my annual workplace medical (a requirement from my work).  Usually my physician calls when she gets my results and says everything looks good!!  This year she didn’t call me…but I could see my test results online and everything looked OK to me so I just forgot about it.

Roll forward to this evening and I log into my health portal to check some test results after a fellow blogger asked me about my AMH levels.  As I was looking I noticed that my physician had added a note to my most recent work place medical test results that said: “Your labs look good.  You are only slightly anemic.  Just take an over the counter iron supplement if you can.  Good luck!”  (She added good luck because I told her about our upcoming IVF cycle).  So all this time….I could have been taking an iron supplement and I haven’t.  I already take prenatals that has extra iron in it so what would my results have been if I hadn’t been taking this? Ugghhhhh.  I’m annoyed because I wonder if this could have made a difference to our embryos?

My doctor in the UK prescribed me folic acid supplements.  A quick google search and all of this and being slightly anemic is likely to be related to my Irritable Bowel Syndrome.  I wonder….is it about time I go and get all things associated with my bowels checked out again after the IVF?

I can’t help but feel frustrated that I didn’t see this message from my physician earlier!  But at least I have seen it now and that is the important thing (thank you Leslie for prompting me to log into my account!!! I’d never have seen the message for probably another 10 months!!).

The hysteroscopy

I am insanely missing my blog right now!  I have been so busy with work and other things that my blogging has suffered, and I am constantly thinking about things I want to write about and get out of my head, I just haven’t been able to.  There is definitely a truth in writing being a form of therapy…a therapy I’ve come to rely on and when it’s not there I start to get itchy.  Anyway, I am here!  Briefly albeit 😦

Today I woke up at 4AM and could not get back to sleep, I won’t lie, I was a little anxious about the hysteroscopy procedure today.  We got up at 5AM so I could shower before inserting the cytotec pills into my vagina!  Nice.  We arrived at the clinic at 6:30AM and the nurses were great as usual.  I was first on the surgery list, a few other ladies were there for their egg retrievals after me.  I got changed into my beautiful one size fits all, modesty covering gown and climbed into a bed with freshly warmed sheets and a couple of extra because I get so so cold in that prep/recovery room!  I signed my life away and took the obligatory pregnancy test.  It would be miraculous if I was pregnant and we all joked about how we all would be happy if I had to be sent home because it turned out to be positive.  No such luck.

The nurse prepared the back of my right hand for the IV needle.  I have wonderful veins, but the nurse managed to bust it and it started swelling up like a balloon.  I started to feel faint like I was about to pass out.  I’m not a needle fan so watching this made me feel sick.  So she tried again but on the inside of my forearm.  She got the needle in, but it felt really, really weird.  She wasn’t happy with it, so she called another nurse to come take a look and try on my other hand. I was feeling really light headed at this point, so she lay me down almost completely.  The other nurse had done my IVs both times previously, so I started to feel a little better when she attempted to insert the needle in the back of my left hand.  She also used lidocaine to numb the area first so I was instantly less nervous because I couldn’t feel the needle jabbing around inside me!  Finally, the IV was in!

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Pre-sedation! The nurses wrapped me up all nice and snuggly

Chris came back to keep me company whilst we waited for my doctor to arrive.  After about 20 minutes she arrived and asked if I had any questions; I may have mentioned this before but she has a real awkward bed side manner, it is actually now growing on me!  Then the anesthesiologist gave me a cocktail of drugs through my IV, and I started to feel like I had 4 or 5 strong margaritas (apparently margaritas was what he was putting through my IV!).  I was wheeled on my bed through to the operating room, and I concentrated really hard on looking around the room to see what it was like.  But that lasted 30 seconds and I was out.  Next thing I knew, I was waking up with Chris next to me, and everyone was laughing and joking at me because I had apparently been dancing to Elton John music in the surgery. Hmmmm.  OK, if that’s what you say!  I think it might actually be credible thing I’d do!

I vaguely remember them also saying that everything looked good on the camera and they had taken a biopsy to be sure.  I had to ask Chris later if I imagined this conversation because I wasn’t sure if I had dreamed it!

I was really, really sleepy coming out of this cocktail of sedation drugs compared to my egg retrievals. I struggled to wake up and felt very woozy. I asked the nurse if the drugs were different, but she said they were the same, they may have given me a little more this time, or just being tired and stressed can make recovery time longer.  Well, both of those things are true so I guess that explained it.  After an hour of coming out of the operating room, I was ready to be driven home.  We stopped off at Panera bread to buy some breakfast treats.  I also ordered a decaf caramel latte and when I took a sip of it I was convinced it had no coffee in it at all!  It just tasted like steamed milk to me.  Chris tried it and said that it definitely had coffee in it.  I didn’t believe him, miffed,  I didn’t drink anymore of it until I got home, when this time I took a sip it definitely had coffee in it!  So something weird was going on with my taste buds!  I attempted to eat my giant cinnamon roll, but my mouth was sooooooooooo dry I could barely swallow a mouthful.  My throat is sore and my mouth dry now still!  Well at least this time I don’t have a drippy nose!  Ah well, I think I would rather have been sedated than have none, so I can’t complain in the grander scheme of things.

So once again, everything looks normal.  We still have no explanation as to what may be wrong.  I  am pleased that there is nothing obviously wrong with my uterus (well, I am still waiting for the results of the endometrieal biopsy they took whilst they were in there today!).

Tomorrow I will phone and see what the plan is for starting IVF round 3 because my period is due to start 3 days before my results appointment, so I need to see if they will start me on down regulation before the results.  I also don’t really know much about their lupron down regulation protocol and how long they do it for.

For now I have a very busy week ahead of me, but I have a quieter weekend coming, so I hope to catch up with the blogging then and get me some blog therapy in!

The Pre Hysteroscopy Surgery Appointment

The nurse called me back and directed me to the toilet.  I told her I had literally just gone to the toilet 2 minutes before she called me and that I apologised profusely that I did not know I was required to do a pregnancy pee test! Whoops!!!  But the silly thing is that almost two weeks ago we did a blood test after IVF cycle 2 and it was a big fat negative.  I am currently on Cycle Day 11 so it would actually be a miracle if I was pregnant right now!! But hey, I guess stranger things have happened.  The nurse took my blood pressure and temperature as usual, but this time we did something different!  A finger prick to test my hemoglobin levels.  I told her it’s always fun to try something new at the clinic, just to mix it up a bit!  I suggested a fertility test card bingo game, I might be on way my way to winning by now!!  Winning what exactly, I’m not sure…

The nurse explained that she was going to order in to my pharmacy a prescription of two cytotec pills that I need insert vaginally an hour before arriving for my hysteroscopy next week (basically I will need to do that at 0530 on the day of the procedure!!! :-s).  Cytotec is actually primarily used to prevent stomach ulcers when taking Non Sterodial Anti Inflammatory Drugs such as Ibuprofen or aspirin.  But cytotec does have an off label use – to ‘ripen the cervix’ (Haha I love the fact that one ‘ripens the cervix’ like an apple or banana)  Basically it helps dilate the cervix so it is easier for the camera to get into the uterus.  So this adds 4 types of drugs I’ve used during infertility treatment that is off label use – Letrozole, vivelle dot estrogen patches, methotrexate and now the cytotec. Off label use means that the FDA hasn’t approved that drug for the manner in which the doctor has prescribed it.  But all of these drugs are commonly used off label, so I am not worried about it.  But at no point have I ever been told these are drugs are being prescribed off label.  It’s an interesting practice!  I digress….

After being prodded and poked by the nurse I saw my doctor who went over the procedure with me and updated my medical history.  The procedure is relatively simple.  I arrive at 0630 AM at the surgery operating room, they get me prepped and ready in a fabulous gown.  No eating or drinking after midnight until after the procedure.  No make up, jewellery etc.  Similar to the egg retrieval.  The anesthetist will give me a cocktail of sedation drugs, probably similar to ones to the egg retrieval.  Once I am knocked out, they insert a camera through my cervix into my uterus – there are no cuts required.  Then they take a look around.  If there is anything there that shouldn’t be there, they will remove it there and then.  They will probably also take a biopsy of my uterus.  The whole procedure typically lasts 15 minutes.  Then I am back out of surgery into recovery for about an hour for the sedation to wear off, then I am driven home by my lovely, patient, husband.  So it really is a quick and simple procedure.  I might be in a bit of pain afterwards, but there is no requirement for me to rest afterwards, however, I won’t return to work until the next day because of the anesthesia drugs.

Simples!

Finally after my doctor gave me the low down and I signed my life away for all potential risks, I moved to the business admin office to pay my dues.  Here is the complicated bit.

My insurance provider is United Healthcare.  Well kind of.  My actual insurance company is Allianz.  I work for an international organisation where the majority of its employees work in Europe, but there are a small number of us here living in the US, so although Allianz provides us with worldwide coverage, it doesn’t have a primary market in the US.  So, Allianz pays United Healthcare to be the ‘front man’ for all of us employees who live in the US.  This means that Allianz gets access to all the in-network negotiated benefits and doesn’t have to worry about administration costs of billing etc in the US.  So all my healthcare providers bill to United, United then bill Allianz.

Have I lost you yet???!!

For anything dental or vision I have to pay for it upfront then claim it back from Allianz, then they re-imburse me 90%.  But I also have the choice of paying for any other healthcare service upfront and then claiming it back directly from Allianz,  I don’t have to go through United.  Most of the time this isn’t beneficial because of the in-network negotiated costs can sometimes be ridiculously discounted so it is better to go through United.  Except in the case of my hysteroscopy….

United demand that the hysteroscopy procedure is performed at a hospital and not the clinic.  If it is not performed at a hospital they won’t pay up.  If I went to the hospital, there is a longer wait time, particularly co-ordinating it so my doctor from the clinic can go to the hospital to do the procedure.  Then there is the high cost of doing it in a hospital – approximately $20 000!  Now, there would be in-network discounts on that, but still that is a lot of money when you compare it to what my clinic charges – just $1300 if you self pay.  Also, it is also far more convenient to have the procedure done at the clinic, especially as I know their surgery room well now!  So it doesn’t take a rocket scientist to work out what needed to be done.  Today I payed the $1300 ($400 of it in cash for the anesthetist, sounds dodgy right??!) , and then I will claim that back from Allianz directly in a couple of weeks time when I get the itemised bill.   Allianz don’t care where I have it done as long as it doesn’t cost more than the limit.  This made me think may be I could pay for all my IVF treatment upfront and claim it back – I reckon I could save about $500 if I did that.  But then I remember how many bills I got through and realised that there is no way I could easily track all of that and then track all those claims to Allianz in addition to also handle the pre-approval process.  I did that for my IUIs and it was a headache.  It’s not worth the stress.  Even if it were to give me a crap load of credit card points!!!!

Insurance in the US – what an absolute nightmare.  But I think I probably have it easy despite the unusual arrangement we have with United & Allianz.  I have it easy because I have amazing infertility coverage, and for that I am truly grateful.

Anyway, here I am, ready to go now for my hysteroscopy procedure next Tuesday!!! Who’d have thought I’d be excited for a diagnostic procedure that requires anesthesia!  This is what infertility does to a woman, it turns you into a masochist-craaaazy!

Good plan batman

First of all, let me say a big thank you to everyone who showed us support by commenting on my last update.  It has been a really difficult weekend.  Full of emotional roller coasters.  Chris and I have been brought to the edge with our sadness and confusion about our second failed IVF cycle.  I couldn’t reply to your comments without crying.  I am sure some of you who have been there have felt that overwhelmingness.  I read each and everyone one and they mean a lot, so thank you for your support.

Today we had our follow up appointment.  Chris and I prepared for the meeting the only way we know best….by making a list.  We wrote a list of all possible scenarios for ways ahead on this pudding club hunt.  And then we individually wrote down what we felt about each scenario and exchanged our thoughts.  We discussed where there were differences.  It was difficult and emotional to do as we realised that we agree in some situations, but not in others.  It’s OK at this stage that we don’t agree or have the same point of view, but it was bloody hard and we had some very raw and honest conversations.  We used up a few boxes of tissues 🙂  But what was good about this exercise is that we were ready to come to this follow up appointment prepared for whatever the doctor was going to suggest doing next.

When my doctor spoke to me on the phone to tell me the bad news that our IVF cycle had failed she mentioned poor egg quality, I took away bad things from this when I needn’t have.  This was just my doctor’s first impressions report, she hadn’t really looked into my case in detail or reviewed my history.  But this is what she did at today’s appointment.

Our doctor was very positive and believes that our best chance is to try again.  We expected that, but she ruled out egg or embryo donation for us or the necessity for genetic testing.  Our chances are still high more than 50% success.  We will make a couple of minor adaptations to our next cycle with my medication protocol by switching from antagonist protocol to Lupron (Down regulation) protocol.  I am a good responder to stimulation so she believes this may help improve the egg quality.  We will also carefully review our Day 3 v Day 5 transfer options at the time.  I had some excellent Day 3 embryos this time around, similar to my first cycle when I got my positive.  May be my embryos don’t do as well in the culture afterwards.

But before we go into another round of IVF, I need to have a hysteroscopy.  This is a small surgical procedure where the doctor inserts a camera through my cervix to look at my uterus and fallopian tube opening closely to check for any potential damage from my suspected ectopic pregnancy, scarring or inflammation as well as checking for endometriosis and taking a small biopsy for further testing.  So I am scheduled for my procedure in two weeks time!

We have a plan we are both happy with.  I felt a huge relief off my shoulders because our doctor was genuinely positive for our next round of IVF – and we pushed her about it too (well Chris did!!) – there was no BS-ing!   So all things going well after the hysteroscopy, we are looking at an April IVF/ICSI Cycle:-)

Thank you all for sticking with us through this, it has been hard, but you make it all the better!!  XXX

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Effects of flying and jet lag on fertility pt 1.

I am just returning from yet another trip to Europe, Belgium this time!  This has been my 9th transatlantic trip this year.  Last year I made 10 trips, and the year before that 11.  With an average of a trip every 6-8 weeks I spend a lot of time either sat in a plane or at an airport or, trying not to fall asleep in meetings whilst I try to get over the jet lag!!

Travelling like this is stressful.  I always have a connection to make in the US because I do not live near an international airport, and sometimes I have another connection in Europe as I travel to cities that do not connect directly with the USA so I can often end up with 2 transfers…it can be very stressful making these connections when flights get delayed or security lines hold me up.  For example on this particular trip to Belgium, due to a series of unfortunate and unrelated disruptions it took me 9 hours longer to reach my destination (on top of the planned 14 hours of travel).

I am simply sick and tired of it.  Yes, I get to go visit some cool cities, I am grateful for that opportunity, but it is physically disruptive to my life.  As this is my last trip of the year and I already have 7 trips planned in the first 5 months of next year :-s I am beginning to wonder whether it is such a good idea to do all this travelling.  I am not sure how many of these I will be able to commit to with my next round of IVF coming up.

This got me thinking about how little I know about the effects of flying on my fertility.  Is it even an issue?  Should I be concerned?  So I did a bit of research and here is what I have found so far:

There is currently no overwhelmingly strong evidence that flying has a direct cause of reduced fertility.  However, there are a few studies that indicate that there may be some correlation.

One study I found to be compelling used mice to investigate whether shifting the body clock has an effect on their fertility [1].  The results of this study showed that there may be serious implications for a woman’s reproductive health if her work involves shift work or time zone changes.

To understand the outcome of this study, you need to understand the body clock.  Our body clocks are called circadian rhythms, these are physical, mental and beahvioural changes that follow a roughly 24 hour cycle, responding primarily to light and darkness in the environment.  Your circadian rhythm is produced by your body, but it is also influenced by the environment.  Light is the main thing that influences circadian rhythms – it turns on or off genes that control your internal clock.  Your circadian rhythm can change your sleep-wake cycles hormone release, body temperature and other important bodily functions [2].  (I know travelling certainly screws up my body temperature because I discovered this last year when we were trying to conceive the good old way and I was actually bothering to monitor my temps.)

The researchers of this study found evidence suggesting the severity of circadian disruption may be linked to the severity of pregnancy disruption: mice subjected to advances of the light-dark circle had greater circadian clock disruption and lower reproductive success.  This group’s pregnancy success rate was only 22% compared with the control group of 90%.

WOAH. That’s quite a difference!

So what does this mean?  This means that if this affects mice, there is a good chance it affects humans too – but to what extent remains unknown, more research is needed before conclusions can be made confidently. ….but I couldn’t find anything taking this research further forward.

Now, there have also been a large survey study of flight attendants to examine fertility….there are two interesting conclusions, first that flight crew were found to be more likely to suffer from irregular periods, and also more likely to suffer a miscarriage.  But I find the study designs less compelling, so I’m not even going to write about this in much detail (but you can judge for yourself here).

So is there something that can be done to prevent suffering from the effects of flying and jet lag?  No one knows for sure, but we do know that Melatonin is an important hormone that regulates other hormones…this can be taken as a supplement, but it can also have negative effects on fertility too when taken as a supplement.  And this is what I will talk about in some more detail in Part 2 later this weekend!

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Am I less fertile because I travel trans-Atlantic a lot?

[1]  Summa KC, Vitaterna MH, Turek FW (2012) Environmental Perturbation of the Circadian Clock Disrupts Pregnancy in the Mouse. PLoS ONE 7(5)

[2] Circadian rhythms fact sheet on the National Institute for General Medical Sciences website

The dreaded HSG

I am not going to pretend to be brave here.  I am actually a little bit nervous about tomorrow’s HSG procedure.

The Hysterosalpingogram – AKA the HSG – is an x-ray procedure to check whether the fallopian tubes are open or blocked, and if the uterus is normal.  Iodine dye is inserted into the uterus to allow a contrast to be seen on the x-ray.  It allows the doctor to see on the free flow of the fallopian tubes and any abnormal lining of the uterus.  The procedure is relatively quick -about 5 minutes.  But for me it really was painful.  I took 800mg of Ibuprofen an hour before the procedure as instructed – it still hurt.

For my first test I was naive and had no clue it might be painful, so I wasn’t nervous.  But now, knowing what I know now!  I AM anxious!  The crappy thing is that Chris isn’t allowed in with me, there is nothing more I would like than for him to hold my hand whilst the dye is injected and I feel that burning cramping sensation run through my body.

When I called the clinic to make my appointment the receptionist who now recognises my voice (OK so I bet they don’t have that many Brits as patients) asked me why I hadn’t had an HSG already.  I pointed out I had one in January but I had to have another one after the possible ectopic pregnancy thing and how much I was dreading it.  She was very sweet and apologised, her tone also changed to be more somber for the rest of the call.  Bless, it was nice that she sounded to care. It must be a hard job working in a fertility clinic – it must be a bit bi-polar with so many highs and lows everyday.

Perhaps I will do some meditation to help me relax a little before hand :-s

On the positive side about this – once we have the results of this test we can go ahead and hopefully firm up plans for IVF round 2.

My HSG X-ray with my retroverted uterus (it's hard to see because it's hiding behind the catheter)

My HSG X-ray with my retroverted uterus (it’s hard to see because it’s hiding behind the catheter)

You might be upside down, but you’re gorgeous to me dear Uterus

I have been told by several doctors that I have a beautiful cervix, and today I discovered that my uterus is just as “gorgeous”.  Well these were the exact words of my Reproductive Endocrinologist (RE)!!!

Today was my hydrosonogram (also known as a Saline Infusion Sonogram).  This procedure was the final test I required prior to our IVF treatment.  The hydrosonogram is a procedure where the doctor inserts a catheter into the uterus and injects saline into the uterine cavity whilst performing a transvaginal ultrasound.  The water shows up as dark black on the ultrasound against the white endometrial lining.  This allows the doctor to look for smooth edges of the uterine cavity.  If the ultrasound shows an edge that is not smooth then these rough and lumpy edges maybe polyps, fibroids or scar tissue which could be a possible problem for embryo implantation.

The procedure in itself was an interesting experience.  Greedily, I had three doctors in the room as well as the nurse! The three doctors were: my RE, the doctor whose name I can’t pronounce and performed two of my IUIs, and one of the male student doctors Chris conversed with at our last IUI.  I wasn’t quite sure if my RE was overseeing the procedure, or she had called in the other doctor because she was more familiar with my cervix and therefore inserting the catheter.  Either way, there were a lot of people clambering around my vagina in this one tiny examination room.  It was rather amusing.

First the doctor with the unpronounceable name inserted the speculum, and then peered up from between my legs and showed me the ‘flexible’ catheter and said, “remember this?  Was it this one we used before?”. Ummmm….. “I think so??!!!” I replied.  How am I supposed to know these things???! When she inserted the catheter I could hardly feel it at all.  The speculum was removed with the catheter still in, and then she inserted the vaginal ultrasound ‘wand’.  We could see the catheter on the screen, there was a lot of excitement amongst the doctors.  The nurse was tying to hold something in whilst the two female doctors discussed tactics of why it wasn’t distending with the saline, perhaps the catheter was up against something, my uterus wall…or perhaps it was bent somehow.  Either way, when they removed the magic wand, the catheter came out.  They apologised and said they would try again.  So back in the speculum went (this was only the painful part, no different to a pap smear), the catheter went back in, speculum was removed, magic wand went back in.  And there was a gaggle of excitement as this time it had clearly succeeded; the saline filled the uterine cavity and I could quickly see there was a nice oval shape, with no rough edges on the screen.  My RE told me my uterus was “gorgeous!”.  She took a few shots on the screen, and showed me in 3D my uterus.  With this image it actually looked more like a normal shaped uterus that you see in biology books rather than what I saw on the screen during my HSG x-ray.  You can see from the image from my HSG below that it was upside down.  Today’s ultrasound, it was the right way round and looked almost perfect.  Text book.

My HSG X-ray with my retroverted uterus (it's hard to see because it's hiding behind the catheter)

My HSG X-ray with my retroverted uterus (it’s hard to see because it’s hiding behind the catheter)

I don’t have a copy of images from my ultrasound from today, but I have found a link that shows the difference between a normal and abnormal result from a hydrosonogram.

After all the excitement and the nurse had cleared everything up, suddenly my RE exclaimed! “Wait!  I need to see her ovaries so I can calculate her dosages!” So back in the stirrups I went and the nurse re-prepared everything for another peek inside using the magic wand.  We had a very quick look at my ovaries to count the number of follicles.  As today is Cycle Day 7 I had about 5 or 6 follicles in the right ovary and then a dominant one in my left.  She seemed pleased with this. I mentioned that I knew it was going to ovulate from the left his month because I could feel it.  I can always feel pain in my ovary on the left side when I’m ovulating from this side.  I’m not sure why.  The doctor who’s name I cannot pronounce seemed very interested in this fact. I left wondering why.

All in all, I left with a sense of relief.  But my feelings were mixed.  I was relieved that we can still proceed with IVF and there was nothing seriously wrong that would require surgery, but I had the feeling of frustration. In the back of my mind, we still don’t have an explanation for why we have not been successful in conceiving so far.  Unexplained infertility can really niggle away at your mind.

On a side note, today I have experienced two more pregnancy ‘announcements’.  One whilst I was at the fertility clinic, a lady found out she was being released from the fertility clinic to her OB/GYN.  She kept asking the nurse if she was sure, then she cried a lot (tears of happiness of course) which made pretty much everyone else around cry too.  Including myself.  And secondly another of my colleagues who recently married is pregnant.  Soooo all I’m thinking is – who is the third?  They usually come in threes, right??!

The great dismal swamp – not quite so dismal

For the last nine days I’ve had a break from blogging and we are on a break from trying to conceive.  I needed both a bit of mental break and a physical break, trying to catch a breather in preparation for our ‘Next Steps’ appointment with our RE tomorrow.  But taking a break hasn’t been plain sailing.  I have had a couple of ‘break downs’ in the last few days, mostly ending with me snapping at Chris and/or crying as a a snivelling mess.  Why? Because I hate this limbo ‘not knowing’ business.

Unexplained infertility is a sucky non explanation for why we haven’t been able to conceive so far, even with a little help.  There are so many questions I have that may never be answered…and it is difficult to get out of this hole of asking “why?” and “what if?”.  Chris has been amazing, he is strong and can handle my random outbursts of crying, reminding me not to bottle all up.  But I can see it in him too, he has the same questions as me.  I know at tomorrow’s appointment we will not have many of these questions answered immediately, but it will help make the path a little clearer in the next steps.  It’s the baby steps I need to help keep me sane, a break has so far been physically good for my body but mentally it has been hard.

So where better to get one’s self out of a dark hole?  The great dismal swamp…this place can take your breath away, and can be anything but dismal.  The swamp is huge, over 112 000 acres and in the heart of this wildlife refuge is an amazing lake, lake Drummond, that is an impressive 3000 acres.  Apparently it is one of two only natural lakes in Virginia.

Lake Drummond at the great dismal swamp

Lake Drummond at the great dismal swamp

The swamp also has a lot of history steeped in it, particularly as this is where many fugitive slaves lived, under the cover the swamp land.  I’ll tell you something, the mosquitoes are horrific in the summer.  This wildlife refuge is always so quiet, and it is easy to quickly feel like you are in complete wilderness, it is anything but dismal.

This time of year is renowned for rare warbler birds and many stunning butterflies.  So today we took our bikes and got on the trails.  In addition to the many sightings of deer we were pleasantly surprised to see thousands of hairy caterpillars, munching so loudly it sounded like it was raining in the swamp.

Hundreds of hairy caterpillars and wishes too!

Hundreds of hairy caterpillars and wishes too!

I feel refreshed this evening after our mini trip to the swamp.  No more tears, I’ve promised Chris this, for at least a few more days anyway 😉 I cannot tell you how much I am looking forward to our appointment tomorrow…..

The wish

Chris got some cracking photos today: The wish

Infertility Tests – wands, needles & fishy dye

I scheduled my initial round of infertility tests as soon as I could, but due to work commitments and travel back to the UK for Christmas the tests ran over two more cycles.  Over December 14 and January 15 I had a vaginal ultrasound, cycle day 3 blood work and HSG.  Chris booked his sperm analysis in January.

Vaginal Ultrasound. An ultrasound wand was placed in my vagina to check if I had follicles in my ovaries.  And I had many!  The ultrasound also showed that I was just about to ovulate from my left ovary (which is the ovulation pain I had been feeling earlier that day – it’s nice to know that I can tell which ovary I am ovulating from!!).  The doctor confirmed everything looked healthy and normal. Woohoooo!

Cycle Day 3 blood work.  I was horrified at the amount of boxes that had been ticked on the blood paper work….I calculated at least 4 vials of blood.  I am not good with needles.  I cannot bear to look at them without feeling faint.  Just before I deployed to Iraq I had to ensure all my vaccinations were up to date (all four million of them).  The army nurse asked me how I wasDani thought with needles.  I replied ‘not particularly good’.  He said ‘well now is the time to overcome your fear, I’ll tell you when you can look away’, and then immediately proceeded to jab me four times, after he just laughed, ‘see?  I told you would overcome your fear!’.  I walked away dizzy and attempted to find the toilet to be sick.  I also have donated blood once, and passed out after giving 1/2 a pint.  Apparently even when I voluntarily want to give my blood away my body won’t let me!  This time, for these particular blood tests, the nurse was lovely (despite him coming to the conclusion that I ultimately kill people for a living), he put me at ease straight away.

A big difference between the UK and the US, is that here in the US it is possible to get your blood test results online before your doctor sees them and discusses what they actually mean.  I am not a doctor and I can barely pronounce the name of the tests, so using the internet to help me decipher the results was a TERRIBLE idea!  In the UK you call up your doctor and then a receptionist will tell you if the results were normal or you need to book an appointment.  I am not sure which way round I prefer!!  Anyway, my results were normal.

Hysterosalpingogram also known as a HSG.  I’m not sure any human being would want to have this test performed out of choice. This procedure is where dye is injected through the vagina into the uterus and by using x-rays to see if the fallopian tubes are blocked. I was given an information sheet about the procedure, I felt prepared, and took the 800mg of Ibuprofen as prescribed an hour before.  My friend accompanied me as it recommended that you have someone drive you home afterwards. I am very pleased she was there with me, I couldn’t have gone it alone.

I was a bit nervous, naturally, but it wasn’t until the nurse asked me ‘Are you familiar with the procedure?’, I said, ‘yes, I read up’.  The nurse looked a little worried ‘uhoh you haven’t been reading the internet have you?’.  Now that part made me nervous!  I had not thought to look up the procedure online because the info sheet given to me was sufficiently detailed.

The procedure was very uncomfortable, and painful at parts, it felt like my insides were on fire and I had immediate cramping.  I could just about see the screen with the x-rays on it and could make out that my tubes were flowing freely.  Great news!!!! But the doctor asked me ‘did you know you have a retroverted uterus‘? Nope, no I did not know that.  Well everyday is a school day after all.   The only question I had on my mind at that point, was  what does all of these results really mean?  What will Chris’s results be?  I felt sad and guilty that Chris would be feeling more pressure about his sperm analysis.

Google – Jekyll & Hyde?  After my final test, I went home intrigued, and googled “HSG”.  I am so glad I did not read any forums before going for this procedure, there are some sad and terrifying stories out there.  The nurse was right to look so worried.  A lesson was certainly learned here – I’m going to  keep trusting in the people I am paying lots of money for to look after me.  Maybe I’m being naive, but google isn’t always your friend.